Young female ED ကို လာတာ bilateral lower limb pins and needles sensations
ပထမက from knee to feet
Then ascending symptoms from groin to feet
Proper Neurological Examination
Increased tone
Power 3/5 in lower limbs
Light touch - allodynia
Gait - Unsteadiness
History of Long term N2O use for years
Consistently use for two weeks ( very high dose)
Working diagnosis - Chronic N2O toxicity
Investigation - MMA
Homocysteine acid
CT head - Normal
B12 and folate - normal
MRI spine - awaiting
Mx
Vitamin B12 1mg IM once daily
Folic acid 5mg oral once daily
Literature အောက်မှာထည့်ပေးထားပါတယ်
Young age တွေ နဲ့ အပျော်အပါးများ၏ ဆိုးကျိူး
အခုလည်း new year လာတော့မယ်
သတိထားကြပါ။
Dr.Zin